KEY POINTS:
New research shows that stressed nurses are putting patients at risk.
It follows a spate of nurses facing disciplinary action for a range of serious offences, and has raised questions about the quality of the nursing workforce.
A Massey University study of 3.3 million medical and surgical discharges from hospitals shows that patients are "without any doubt" more likely to die unexpectedly or suffer from complications when nursing turnover is high.
The yet-to-be published research by Dr Jenny Carryer, professor of nursing at Massey, comes on top of another study which revealed that 40 per cent of Kiwi nurses change jobs each year.
The studies follow a string of nurses being struck off the register or suspended for serious offences this year, five in June alone. They include:
* West Auckland nurse Haren Makaea was sentenced to eight years' imprisonment after being convicted for unlawful sexual connection with a man.
* Gayle Plasmeyer of Morrinsville stole morphine she promised to deliver to a cancer patient, taking $16,000 worth over nine months.
* Dunedin nurse Graeme Pollock was convicted of drink-driving - his fifth court appearance - and stealing morphine.
* Auckland nurse Judith Renau took more than $57,000 from a woman she cared for in an elderly care hospital.
* Hamilton nurse Dalip Chand tried to fondle and kiss a co-worker and made midnight phone calls to an ex-patient.
* Wayne Petcher was suspended for six months after being convicted for assault, burglary and assault with a weapon.
Since 2004, 30 nurses have appeared before the Health Practitioners Disciplinary Tribunal on misconduct charges, and since 1997, another 30 nurses have been investigated by the Health and Disability Commissioner.
Glenda Alexander of the New Zealand Nurses Organisation said there was "some truth" in the suggestion that the quality of people who were nurses had dropped in recent years.
"To some degree I might agree, there are some people who have come into nursing who might not have got in years ago, because the whole thing has been opened up with the degree.
"But I suspect that any time a nurse, or any health professional, gets caught out doing something naughty like drink-driving, it hits the headlines."
As for the HDC inquiries, Alexander said that although there had been a number of nursing errors recently, systemic errors were more to blame in a stressful workplace that was short of staff.
"When you get pushed that's when mistakes and errors occur. It's a job where your mistakes... [can be] a matter of life and death."
However, Carryer, who is also head of the College of Nurses, rejected any suggestion that the quality of nurses had dropped.
Paradoxically, she said, it had in fact improved since becoming a degree profession in 1995. Quality of care had fallen because of the stress nurses were under.
"When we ask [nurses] to work under intolerable pressure, it's very hard for anyone to deliver quality under those circumstances," Carryer said.
Forty per cent of staff nurses in New Zealand hospital general wards leave their jobs every year, each costing hospitals an average of nearly $25,000 to replace.
The new study by Auckland University on nurse turnover at the country's public hospitals also found that hospital wards employ two nurses fewer, on average, than budgeted for.
"Nursing has an extremely high turnover of personnel and this is viewed as normal by most people in the healthcare field," associate professor Nicola North, the study's primary investigator, said.
The study did not investigate reasons for leaving, but Professor North said that typically many younger nurses left to gain overseas experience, while others chose to move to other departments or sectors of care.
Though the numbers of nurses who headed overseas is not known, indications are that the figure is high. Nursing Council data show that it receives between 1600 and 2200 inquiries each year from overseas employers verifying nurses' New Zealand registration.
Official statistics show that there were about 29,000 active registered nurses in the country in 2004. Of the replacements, 40 per cent were new graduates and 22 per cent were overseas qualified.
